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Alpha‑Wave Characteristics in Psychophysiological Insomnia [Downloaded free from http://www.jmssjournal.net on Sunday, November 3, 2019, IP: 10.232.74.27] Short Communication Alpha‑wave Characteristics in Psychophysiological Insomnia Abstract Mohammad Rezaei, Individuals with psychophysiological insomnia (Psych‑Insomnia) would show raised cortical Hiwa Mohammadi, arousal through their initiating sleep. Frequent changes in the alpha activity can be indicative of Habibolah Khazaie visual cortical activation, even without visual stimulation or retinal input. Therefore, we aimed to Sleep Disorders Research investigate alpha‑wave characteristics in Psych‑Insomnia before and after sleep onset. In a case– Center, Farabi Hospital, control study, 11 individuals with Psych‑Insomnia (age: 44.00 ± 13.27) and 11 age‑, sex‑, and body Kermanshah University of mass index‑matched healthy individuals (age: 41.64 ± 15.89) were recruited for this study. An Medical Sciences, Kermanshah, overnight polysomnography monitoring was performed. Alpha characteristics were calculated from Iran wake before sleep onsets (WBSOs), wake after sleep onset, rapid eye movement, and nonrapid eye movement in the both groups. They include the alpha power and alpha frequency and their variability in the central region. In the WBSO, alpha activity and variability were higher in the Psych‑Insomnia individuals compared to healthy individuals. In both groups, alpha frequency variability was observed at approximately 1 Hz. Alpha‑wave synchronization in Psych‑Insomnia individuals was higher than the group with normal sleep. Individuals with Psych‑Insomnia have a lot of imagination in the wake before sleep, which can be caused by stress, everyday concerns, and daily concerns. Keywords: Electroencephalography, polysomnography, power‑frequency variability, psychophysiological insomnia Submitted: 28‑Oct‑18 Revision: 07‑Feb‑19 Accepted: 26‑Feb‑19 Published: 24‑Oct‑19 Introduction mechanism and variation in functional correlations along the sleep‑wake rhythm. Electroencephalography (EEG) signals have In addition, the heterologous temporospatial provided new visions to the neocortical characteristics of the electrical microstates dynamic functions at a macroscopic level. in the ben the alpha band reveal a distinct EEG is analyzed to different frequency geometry of active nervous structures under band, including delta (0.5–4 Hz), each alpha variant.[3] theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), and gamma (>30 Hz) by EEG‑based neural analysis has been used signal processing methods. One of the for investigating the neurophysiological favorite EEG frequency bands is the bases of insomnia, but methodological alpha, which is detected either by EEG concerns remain controversial. Based on or magnetoencephalography in the range the absence of alpha enhancement among of 8–13 Hz[1,2] and predominately comes patients with insomnia, Pedneault‑Drolet and Bastien proposed that spectral analysis Address for correspondence: from the occipital zone during wakeful Dr. Habibolah Khazaie, relaxation with closed eyes. Furthermore, is not an optimum method for investigation Sleep Disorders Research it is detected during different sleep stages of hyperarousal in insomnia sufferers Center, Farabi Hospital, with various topographical representations. during REM stages. Since cortical activity Kermanshah University of is more during REM stages, more activation Medical Sciences, Kermanshah, Alpha waves occur in central areas and Iran. migrate to posterior regions in rapid eye in high frequencies can be related to sleep E‑mail: [email protected] movement (REM) sleep. Furthermore, fragmentation.[4] Furthermore, researchers they are centralized in the occipital regions in other study proposed that sensorimotor within intra‑sleep awakenings.[2] EEG and sensory zones in insomniac may yet Access this article online evidence has shown cortical generation be relatively active, even during the deep Website: www.jmssjournal.net sleep.[5] Besides, frequency characteristics DOI: 10.4103/jmss.JMSS_51_18 [6,7] of alpha wave were investigated. Quick Response Code: This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are How to cite this article: Rezaei M, Mohammadi H, licensed under the identical terms. Khazaie H. Alpha‑wave characteristics in psychophysiological insomnia. J Med Sign Sens For reprints contact: [email protected] 2019;9:259‑66. © 2019 Journal of Medical Signals & Sensors | Published by Wolters Kluwer - Medknow 259 [Downloaded free from http://www.jmssjournal.net on Sunday, November 3, 2019, IP: 10.232.74.27] Rezaei, et al.: Alpha wave in psychophysiological insomnia One of insomnia subtypes which has encouraged Materials and Methods researchers to study alpha characteristics of brain waves is Participants and procedure psychophysiological insomnia (Psych‑Insomnia).[2,6,8,9] The common idiom “psychophysiology” got into common use in Inviting participants to sleep laboratory were done 1 day the 1960s and 1970s and represented the effort to prospect before the experiment. They were informed not to have the psychological affections on physiological functioning coffee, cigarette, and heavy diet as well as snooze and sleep during the day of the experiment. They arrived to through the utilization of electrophysiological measures such the laboratory at 9 p.m. The participants completed the as EEG and EMG. Concept of psychophysiology confirms questionnaires. The Pittsburgh Sleep Questionnaire was that the nature of Psych‑Insomnia is determined by both used to assess subjective components. Components include physiological and psychological components. Physiological sleep quality, total sleep time (TST), sleep efficiency (SE), factors consist of conditioned arousal and wakefulness and sleep latency, disturbances, sleeping medication, daytime raised neurohormonal activity. Both cognitive and behavioral dysfunction, and PSQI sleep quality index total. Then, elements are psychological factors. Cognitive factors include the PSG procedure was explained to the subject. PSG comprehend stress,[10] anxiety,[11] thoughtfulness, sudden room was standardized for any noise and visual stimulus memoirs, and attention bias. Behavioral factors include varied based on international standards.[22] PSG signal recording sleep scheduling (expanded sleep chance and snoozing) was implemented based on the American Academy and the propensity to remain in bed when wakeful.[12] of Sleep Medicine guideline on all participants on the [23] Despite a legitimate amount of data on insomnia and its second night according to the method presented into determine the presence, type, and severity of insomnia. overall prevalence, there are little data on Psych‑Insomnia. For recording signal, we used PSG SOMNOscreen According to ICSD‑2, it is only estimated that the prevalence equipment, model SOMNOscreen™ plus PSG constructed and clinical prevalence rates for Psych‑Insomnia are 1%–2% by SOMNOmedics GmbH, Germany. PSG instrument [13,14] and 12%–15%, respectively. includes electroencephalogram scalp sites (F3, F4, C3, Considering the functions involved in Psych‑Insomnia,[15,16] C4, A1, A2, O1, O2, F3A2, F4A1, C4A1, C3A2, O1A2, the importance of alpha qualities in various studies,[17‑19] O2A1); 256 Hz sampling rate in frontal, central, and and that there is not enough data on Psych‑Insomnia occipital zones and six electrooculogram channels; 256 Hz sampling rate that all referenced to the mastoid of the left specifically for the variables of interest,[13,14] it is imperative and right ears for rederivating a connected ears reference that characterization of alpha activity should be further offline [Figure 1]. Rochester Electro‑Medical silver‑silver investigated. This study focused on characterization of chloride electrodes were applied based on the International alpha variability in terms of both amplitude and frequency 10–20 System. In addition, three electromyogram in Psych‑Insomnia that has been largely ignored in past channels (EMG, EMG1, and EMG2), electrocardiographic studies except a study only in the frequency variability in lead II; 256 Hz sampling rate, oxyhemoglobin saturation insomnia generally.[6] Considering that the brain cognitive, by pulse oximetry; 4 Hz sampling rate, and thoracic and behavioral, and physiological function change EEG abdominal respiratory effort (induction plethysmography) amplitude and frequency, three hypotheses were adjusted by inductance plethysmography (Pleth) using piezoelectric H1: both the alpha amplitude and frequency oscillate around strain gauge; 128 Hz sampling rate, flow pressure, and flow a state‑dependent set point; H2: the set‑point amplitude temperature by oronasal thermistor and nasal air pressure and frequency evoke the neurophysiological state;[20,21] and transducer; and 256 Hz sampling rate was used. H3: the amplitude and the frequency variability may be The type of disorder was diagnosed by a sleep specialist. different between Psych‑Insomnia and normal sleepers. Objective data were derived from PSG results and also monitoring by expert technician. Subjective data were The study is organized into five sections. Section 1 obtained based on subjects’ reports and clinical interviews describes the assumption of the study briefly along on the diagnosis of sleep disorders. Next, the final with the literature review
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